Wednesday, July 8, 2009

Bought and Paid For

Although many healthcare groups have promised their help in reform, major players are hiring former congressional staff members and retired members of Congress as lobbyists in a campaign to block reform.

In a $1.4 million a day plan, the “The nation's largest insurers, hospitals and medical groups have hired more than 350 former government staff members and retired members of Congress in hopes of influencing their old bosses and colleagues.”

Of note, former House Majority Leader Richard Armey and Richard A. Gephardt are now lobbying for a New Jersey pharmaceutical firm.

Many insiders formerly worked with lawmakers, such as Senators Max Baucus and Charles Grassley, on committees concerning whether or not a public insurance plan should be implemented--a policy opposed by the healthcare industry.

“The push has reunited many who worked together in government on health-care reform, but are now employed as advocates for pharmaceutical and insurance companies.”

Two former chiefs of staff to Senator Baucus, who chairs the Senate Finance Committee, are David Castagnetti and Jeffrey A. Forbes. Both men, now lobbyists, collectively represent such clients as: PhRMA, Merck, Genetech, Amgen, and America’s Insurance Plans.

Castagnetti and Forbes were amongst those who attended a June 10 closed-door committee meeting between aides to the Senator and other healthcare lobbyists. Another attendee was Richard Tarplin, who previously worked with the Department of Health and Human Services and Senator Dodd, a leader in reform.

Currently, Mr. Tarplin heads Tarplin Strategies, a lobbying firm that represents the American Medical Association. Mr. Tarplin sees his role as a lobbyist as being important, because, as he states:

"For people like me who are on the outside and used to be on the inside, this is great, because there is a level of trust in these relationships, and I know the policy rationale that is required."

Refuting that, however, are those who work to protect the pubic interest. They are concerned that the revolving door between government and K Street has altered the healthcare debate.

“ ‘The revolving door offers a short cut to a member of Congress to the highest bidder,’" said Sheila Krumholz, executive director of the Center for Responsive Politics.”

A well-known example of the revolving door is Rep. Billy Tauzin, who, after being successful in moving the Medicare prescription bill through Congress, became the head of PhRMA--where he received a starting salary of $2.5 million a year. That appointment led Congress to pass a bill barring former members from such activities as, “bringing clients onto the House and Senate floors and from lobbying their friends in members-only gyms.” It also “forbade direct lobbying contacts with former colleagues for a year in the House and two years in the Senate.”

Mr. Tauzin argues, however, that it’s not unusual that experienced individuals get the job. As he puts it:

"Is it a distortion of baseball to hire coaches who have played baseball? Is it a distortion of universities to hire from academia?"

"The bottom line is that people work in the fields in which they have experience. Somehow there are people who think that's unusual for politics, but I think it's pretty normal."

I guess so. But we are not playing baseball or looking for the best teachers. We are not looking for more conflicts of interest. We are looking for and need to trust in someone who will watch over us.

What is your opinion of former employees of Congress working as lobbyists for the healthcare industry?

If you find that policy unhealthy, what should we do about it?

For the full article, please see: Former Lawmakers and Congressional Staffers Hired to Lobby on Health Care - by Dan Eggen and Kimberly Kindy , July 6, 2009


  1. As I recall, we've touched on some of this before. I believe there is at least a "statute of limitations" before a pol can become a lobbyist. That may well not apply to a staff person.

    As I recall, there is also a full ban on a pol (but not a staff person) lobbying on an issue about which they were directly involved or had "insider knowledge" from their "public servant" role that could benefit their client as a "private servant." Someone else can probably clarify the particulars. Tauzin was obviously no stranger to pharma-related issues while in Congress. (Apparently, the industry made at least a token donation to his war chest even after he announced he would not be running again).

    In any event, it would be relevant to me to know more about what limits there are/may be on revolving door work.

    I am personally more concerned about industry influence while pols are still in office. It is well known (as described in Alicia Mundy's book) that Rep. Tom Lantos worked (successfully) to head off an FDA meeting on fen-phen's safety, even when the then known risks were becoming increasingly publicized. Lantos was close to members of the board of Interneuron, the company that "developed" Redux, none of the fens that became part of the cocktail. Interneuron "happened" to make a large contribution to Lantos's campaign that year. A few months later, they were solicited for a contribution to the campaign of Lantos's son-in-law.

    Until recently, I did not know that Ted Kennedy also intervened on Interneuron's behalf, also in the context of knowing about the kind of influence companies can have over what FDA does and does not do. (Kennedy had initiated hearings on precisely that issue some years earlier, featuring FDA reviewers who claimed to have been pressured into approval against their own scientific judgement.) Sound familiar?

    And, in recent months, we've heard about a number of other pols--many who are often vocal critics of the industry--intervening on behalf of a drug or device in the last stages of review.

  2. To keep the bipartisan, multi-issue pot boiling--

    Would it be any different if Al Gore was hired by companies that manufacture wind and solar power generators to lobby Congress on sustainable energy issues?

    Same question, I assume, yes?

  3. Regarding Al Gore, it would depend on how long he had been out of office. The limits the Post described that “forbade direct lobbying contacts with former colleagues for a year in the House and two years in the Senate,” are worthless. A minimum of five years would be more appropriate.

  4. OK, so I'll push the point. If Dick Armey and
    Dick Gephardt had waited five years, would that have been OK?

    Or would they still essentially be two Dicks?

  5. Justice –
    To me the bottom line is that politicians get great perks for allowing someone to manipulate their vote and the industry gets its agenda written into law.

    I’m sure that there is some degree of “education” involved but at what price to the voter?

    Time limits for ex-politicians seem to be just an attempt to pacify the incredulous voter while maintaining the status quo of money changing hands for votes.

    So to answer your question - I don't think time limits matter. Using a newly ex-politician probably just saves the industry a little money and/or time by being more accurate in the administration of the poison. But either way the poison will be adminstered.

  6. Obviously, I'm being the "devil's advocate"--almost literally!

    Beyond what Dianne noted, I recall that somewhere there are other guidelines we dug up here, but this may apply to other aspects of the revolving door.

    In any case, as I emphasized above, I am more concerned with the ways pols can be bought while they are still in office--even those one might imagine would less "malleable."

    On the issue of becoming a lobbyist later, I do think it pushes us to think harder about the question if the relevant industry/issue is one we personally feel good about.

    Thus my example (which will fit that for some) of Al Gore working with renewable energy companies as a lobbyist in the arena of energy policy.

    Or here's a hypothetical (if indulgent fantasy). Sid Wolfe runs for Congress and wins. After a couple of terms, he returns to Health Research Group/Public Citizen. Would you ban him from lobbying in the arena of health policy?

  7. If Dr. Wolfe won a seat in Congress I would not want to ban him from health reform lobbying. However, I can’t say that about everyone in Congress, so any ban would have to be absolute.

    Speaking as a private citizen, I believe it should be illegal for politicians and their staff members to have any agreement with industry prior to a five year time limit. That doesn’t stop people from being influential, but it slows them down.

    If Americans understood the impact of lobbying and we could put the issue on the ballot for a vote, the consensus would probably be overwhelmingly against these kind of lobbying efforts.

    Regarding Los Dos Ricardos. It would have been better if they had waited five years, but they’d still be a couple of dicks.

  8. Diane writes:
    "Speaking as a private citizen, I believe it should be illegal for politicians and their staff members to have any agreement with industry prior to a five year time limit."

    I've pointed this out before, I hope you aren't singling out "industry" as the evil party here. If you are going to make it illegal for former politicians to be lobbiest, you have to also lump in all these "evil" lobbiest too:
    *US Chamber of Commerce (biggest lobbiest BY FAR over the last 10 years -- outspent PHRMA by ~5x!)
    *AARP (spending ~equal with PHRMA)
    *US Olympic Committee
    *American Legion
    *Boy Scouts
    and the list goes on and on and on

    Lobbying isnt' inherently evil. It's a way for groups of citizens to get thier voices heard by congress about a specific issue. In the case of "industry", that group of people just happens to be shareholders and employees. You seem to view PhRMA as somehow more evil than other lobbying groups. In the eyes of the law, these groups are all equal and must be treated equal. PhRMA or the Red Cross. It doesn't matter.

  9. This discussion usually leads to some version of the question, "So former pols shouldn't be able to get work after they leave the public sphere?"

    Obviously, we are talking here about a very specific kind of work.

    Personally, the nexus between many pols and industry is already so close that I am less concerned about their taking a "different position" on the payroll after they leave office. But the limits in place, however minimal, are obviously there for a reason.

    Philosophically, the issue comes down to the extent that the privilege and knowledge that come with public service should be a commodity that can be traded for a job representing special interest, whatever that interest is, and however noble or not we believe it to be.

    A total ban does not make intuitive sense to me. Time frames seem relatively arbitrary, whatever they are. But it also seems there are some arenas (for example, going from the DoD to arms makers) that seem, well, uncomfortable.

  10. Nathan makes the same point that I have been making. Again, though, the issue is not that there is something inherently "evil" about lobbying (for whatever cause).

    It is the ethics of using what is essentially public property--what belongs to all of us as citizens, and funded by our taxes--and trading it for private interest.

    I also think there _is_ a relevant distinction to be made between private interests that are profit-making (whatever the specific industry) and those that are not, like the Boy Scouts.

  11. Uncle Ed posted on this a couple of weeks ago. He cites a CRP overview that includes a list of 30 former Congressfolks and which companies or trade organizations (e.g. PhRMA) they now lobby for.

    Find it at:

  12. No, Nathan, I am not singling out "industry" as the evil party. However, our government has an obligation to protect the interests of its citizens. Do you trust that they will do that when offered excessive amounts of money? And I am not suggesting a total ban on lobbying. However, I do feel that a 5 year minimum moratorium for any government employee/politician would serve as a buffer.

  13. This may sound crazy but why wouldn't we want to eliminate all lobbying that involves any sort of gifts?

  14. David,
    Give me an example. Generally gifts (of substantial value) are already banned from what I understand. Granted, there are probably some lavish parties, dinners, and maybe travel that is paid for. But overall, "guid-pro-quo" type of gifts are illegal. Am I wrong?

  15. What is a "quid-pro-quo" gift?

    Does there need to be some explicit communication or documentation that the gift influenced Rep. Hoozit's vote?

    Good luck _ever_ finding that sort of documentation that cannot be easily denied.

  16. Who's "Rep. Hoozit"? Is that a real person?

    All I'm saying is that I want some specific examples of gifts that congressmen are being given that you (or David) believe should be outlaws.

  17. Nathan, some examples - Jack Abramoff, John Murtha...
    In my mind the allowance for lobbyists to contribute to political campaigns, regardless of the expressed intention, should be eliminated. A list of Congressional members in this catagory would be too long for this blog

    Actually any gift of any kind should be banned, just like branded pens in the doctor’s office.

    Just my way of thinking.

  18. Wait, wait. 1st, please don't name "a list too long for this blog". I want specific gifts (and links) that you think are inappropriate. Sure, we always complain vaguely about politicians being slimy. This isn't a place for that. If you want a particular practice to be made illegal, please name some specifics. Jack Abramoff is in jail and John Murtha was investigated by the FBI and there wasn't any evidence of specific wrongdoing. (only "intent" to take a bribe - not ACTUALLY taking a bribe)

    If these two are your best examples, then I say the current system is working just fine!

    Secondly, now you want lobbying groups not to contribute to political campaigns? As the SCOTUS has weighed in, this is a free speech issue. A group of citizens (whether representing a company or an interest group) CAN use thier money to make political statements (within reason, hence the McCain/Fiengold Act).

  19. Actually, Abramoff is probably the ultimate example.

    But my point was that having evidence of explicit quid-pro-quo is very rarely available. That obviously does not mean it doesn't happen.

    As far as my own views more generally, they are expressed several times above. Banning is not something I suggested. I have myself been a "lobbyist" (unpaid) numerous times in Michigan if that means conveying my views to state reps. Quotation marks, of course, because I have been entirely unfunded beyond my own paying for a tank of gas to Lansing.

    Also true that the only "gift" they ever got from me was the pleasure of my opinion.

  20. Anyway, we're drifting off topic, which was former elected officials being lobbyists.

    Nathan--do you think even the one- or two-year hiatus is a bad idea?

  21. Nathan,
    Here's the list (below) but I cut it off at $10,000 because it really is too long. And here's the source Embattled Lobbying Firm PMA Targeted Members of Defense Committees.

    Also concerning what SCOTUS says - It may be legal but I still don't think it's right and neither would our founding fathers. To them lobbying was a threat to Democracy. Refer to 22nd article of the Federalist Papers.

    List of lobby money given to Congressional members
    Name Total
    Rep. Pete Visclosky (D-Ind) $271,500
    Rep. Jim Moran (D-Va) $171,200
    Rep. John P. Murtha (D-Pa) $167,400
    Rep. Norm Dicks (D-Wash) $130,250
    Rep. Tim Holden (D-Pa) $96,075
    Rep. Mike Doyle (D-Pa) $91,900
    Rep. Bill Pascrell Jr. (D-NJ) $91,750
    Rep. Loretta Sanchez (D-Calif) $83,618
    Rep. Alan B. Mollohan (D-WVa) $69,620
    Rep. Michael E. Capuano (D-Mass) $69,000
    Rep. Tim Ryan (D-Ohio) $64,250
    Rep. Chet Edwards (D-Texas) $63,984
    Rep. Jerry Lewis (R-Calif) $61,809
    Sen. Bill Nelson (D-Fla) $51,213
    Rep. Silvestre Reyes (D-Texas) $44,800
    Rep. John B. Larson (D-Conn) $42,350
    Rep. Rodney Frelinghuysen (R-NJ) $42,162
    Rep. Paul E. Kanjorski (D-Pa) $42,150
    Rep. Marcy Kaptur (D-Ohio) $41,500
    Rep. Carolyn McCarthy (D-NY) $40,300
    Rep. Chris Carney (D-Pa) $40,000
    Rep. Steny H. Hoyer (D-Md) $37,991
    Rep. Ander Crenshaw (R-Fla) $37,350
    Rep. David R. Obey (D-Wis) $34,000
    Rep. Jason Altmire (D-Pa) $32,250
    Rep. Allyson Schwartz (D-Pa) $31,500
    Sen. Dick Durbin (D-Ill) $31,250
    Rep. John L. Mica (R-Fla) $30,390
    Sen. Ben Nelson (D-Neb) $30,350
    Rep. Zach Wamp (R-Tenn) $28,900
    Rep. Patrick J. Murphy (D-Pa) $28,750
    Rep. Todd Tiahrt (R-Kan) $26,750
    Sen. Judd Gregg (R-NH) $26,500
    Rep. John M. McHugh (R-NY) $25,700
    Sen. Patty Murray (D-Wash) $24,000
    Rep. Ike Skelton (D-Mo) $21,250
    Sen. Arlen Specter (R-Pa) $20,450
    Rep. Neil Abercrombie (D-Hawaii) $19,750
    Rep. Mike Honda (D-Calif) $19,200
    Rep. Stephen F. Lynch (D-Mass) $19,000
    Sen. Dianne Feinstein (D-Calif) $16,839
    Rep. Adam Schiff (D-Calif) $15,800
    Rep. Susan A. Davis (D-Calif) $15,500
    Rep. Brad Sherman (D-Calif) $15,500
    Sen. Barbara A. Mikulski (D-Md) $15,300
    Rep. Jerry Moran (R-Kan) $14,750
    Rep. Allen Boyd (D-Fla) $14,250
    Rep. C. W. Bill Young (R-Fla) $14,250
    Sen. Susan Collins (R-Maine) $14,250
    Sen. Jack Reed (D-RI) $14,150
    Sen. Olympia J. Snowe (R-Maine) $13,650
    Rep. Gene Taylor (D-Miss) $13,500
    Rep. Jo Ann Emerson (R-Mo) $13,500
    Rep. Frank R. Wolf (R-Va) $13,250
    Rep. Jack Kingston (R-Ga) $12,750
    Rep. Jane Harman (D-Calif) $12,500
    Sen. Mark Warner (D-Va) $11,900
    Rep. Jerry F. Costello (D-Ill) $11,650
    Rep. Walter B. Jones Jr. (R-NC) $11,500
    Rep. Patrick J. Kennedy (D-RI) $11,500
    Rep. Maurice Hinchey (D-NY) $11,500
    Rep. Jim Marshall (D-Ga) $11,500
    Rep. Michael R. Turner (R-Ohio) $11,250
    Sen. John Cornyn (R-Texas) $11,000
    Rep. Hal Rogers (R-Ky) $11,000
    Rep. James L. Oberstar (D-Minn) $10,750
    Sen. Lindsey Graham (R-SC) $10,500
    Rep. Anna Eshoo (D-Calif) $10,500
    Sen. Hillary Clinton (D-NY) $10,350
    Rep. Jerrold Nadler (D-NY) $10,000
    Rep. Jim Matheson (D-Utah) $10,000

  22. I guess I would qualify my definition of lobbyist.

    One who offers information for free - lobbyist. I have no problem with that.

    One who offers information and a "gift" or information and money to support the receiver's career - backhander (briber)

  23. I have to agree with David. We all have to remember that these people are elected officials to represent "we the people". They get paid to do their jobs with the money the government collects from us in the form of taxes. We elected them and put them in office, wy should they get money and other gifts when they are supposed to be doing their jobs?

    If you accept gifts, how non-partisan can you be?

    To Justice's question, I think former politicians should be forced to wait five years before becoming lobbyists....

    Great Thread here...

  24. There are several different topics being discussed at once here.

    1. Former Congressfolk acting as lobbyists (the original topic of the thread).

    2. Professional (i.e., registered) lobbyists, lobbying.

    3. Professional lobbyists including in their lobbying what can be construed as a "gifts" (lavish parties, sports excursions, various "favors,"., etc.)

    4. Campaign contributions.

    5. Evidence of some sort of quid-pro-quo in which pol directly "returns the favor" of a lobbyist gift or contribution by voting or not voting a certain way.

    While related issues, I think they've gotten pretty jumbled in the discussion.

    So let's look at one specific instance. The Chamber of Commerce and PhRMA have lobbied very hard in Michigan against repeal of our absolute drug industry immunity (preemption with no exceptions). How have they done this:

    --Ghostwritten op eds published under whatever name of convenience.

    --Prepared "talking points" for pols they already have on their side.

    --Explictly let it be known that the presence or absence of campaign contributions, or any other kind of support, will depend on how pol votes. Direct suggestion that will support alternative candidate if pol votes otherwise.

    --Pols themselves soliciting lobbyist support--in all the ways above--in light of having acted as lobbyist wanted.

    Which, if any, of the above should be made illegal or otherwise further limited than they already are?

    From my personal perspective,the fact that all this goes on--and can be repeatedly shown to go on--helps my own cause. People like to hate lobbyists almost as much as pharma and trial lawyers. While it is true that the Chamber of Commerce has "more money than God" (to quote Phillip Morris), and can seriously influence votes (as some of the pols have themselves acknowledged), I am not sure having this all out there isn't useful. If it smell like S, etc....

    As for what is ideal, we are, in my view, not close to the kind of campaign reform I'd like to see, but there have been a few small steps ("soft money," etc.)

  25. This addendum--I've learned that a good many state pols are not, shall we say, the sharpest knives in the drawer. Some are big hair with not much undereath. When that big hair and not much underneath can be linked with relevant puppeteers, it's not exactly a travesty.

  26. Nathan wrote: "I want specific gifts (and links) that you think are inappropriate."

    I named at least one in the opening response--Lantos's directly lobbying the FDA, on behalf of Interneuron (already acquired by Wyeth/American Home), to cancel a public hearing on fen-phen's safety. This followed up by significant contributions of Interneuron to Lantos and his son-in-law, the latter solicited.

    Illegal? Probably not. Inappropriate? Even some of the execs at Interneuron called it, literally, "inappropriate." Some of the FDA officials who went along with it expressed their doubts privately about its propriety.

  27. It's illegal. But of course, in the drug industry it's not seen that way. Bribes-in any form are just the cost of doing business, patients with side-effects? slight problem, if they make noise, but congress can take care of that. Pay the politicians a lot of bucks to have a word with the FDA.

    lantos etc. put the lot of them on a risky drug-I think one of the me-too CNS drugs would be appropriate- something that treats ineptitude-side-effects (many and dangerous)-but suppressed to all-except the drug company.

  28. Justice,
    The long list you provided are for campaign contributions, right? If that's the case, I don't really have a problem with it. To me it is a free speach issue: Within reason, companies and individuals should be free to express thier views by giving thier dollars and thier time, expertise, etc to whatever political party or persona that they would like. Now, the "within reason" part is where I'm sure we will quibble.

    As for your second post, I'll re-quote the 5 items you state and give my opinion:

    1. Former Congressfolk acting as lobbyists (the original topic of the thread): In general, I have no problem here. But maybe to make things
    "cleaner" we could cap pay for these people at no more than ~1.5x salary of a US Senator? (~$300k per year I think)

    2. Professional (i.e., registered) lobbyists, lobbying: Again, I have no problem here. Lobbying is a perfectly legit career and a needed service for both industry and for nonprofit interest groups.

    3. Professional lobbyists including in their lobbying what can be construed as a "gifts" (lavish parties, sports excursions, various "favors,"., etc.): I don't know if there are limits here, but certainly there should be. It's one thing to have a nice evening party at a DC hotel. It's another thing to fly everyone to the Carribian for the weekend...

    4. Campaign contributions: As long as there isn't a quid-pro-quo agreement going on, then I have no problem. It's only logical that industry groups would donate money to those groups that agree with thier viewpoint.

    5. Evidence of some sort of quid-pro-quo in which pol directly "returns the favor" of a lobbyist gift or contribution by voting or not voting a certain way: this is generally illegal already, right? But I agree that it would be nearly impossible to prove in court. Can a lobbyist actually make a campaign contribution? For instance, in the case of PhRMA -- I suspect that PhRMA makes campaign contributions -- but they don't actually lobby directly. Rather, they contract with other lobbying groups. Am I incorrect? I agree that this one is tricky.

  29. Hi Nathan--the list came from David, not me.

    Beyond that, I think we are in essential agreement on the other points, including the last one about donations and lobbying being separate (if related) activities.

    Based on my Michigan experience, I think you are right that PhRMA typically works with lobbying agencies, as do individual companies. Whatever it means, I have also met some lobbyists who represent specific companies--I think, directly.

    Staying local, it has been striking to me how coordinated the efforts have been between the Chamber of Comm, PhRMA, BIO, individaul companies, some HCP PACS,and others. They issue separate talking point lists under their own letterheads, but the talking points are, word-for-word,identical.

  30. My perspective on the points:

    1.) Former congress folk should be barred from acting as lobbyists for at least five years after ending their political service. There really should be more of a detterent, capping pay doesn't solve the problem. Entering into political service should not be seen as a mere stepping stone to eventually working as a lobbyists, which is apparent with some politicians that we know of.

    2.) No problem with item 2, as long as there are no elaborate gifts, and there is no "quid pro quo".

    Justice, to your last paragraph, of course there is a close alliance with industry and local governments. Industry employes a lot of citizens, pays higher taxes in the municipalities where there facilities are located which beneftis everyone in the community, they are and can be strong influencers of local politics. So much for "quid Pro Quo" Huh....

  31. HERE is a dated but interesting article by The Center For Public Integrity about Pharmaceutical Lobbying.

    A more recent article from the HEALTH REFORM WATCH gives an idea of today's numbers.

    I like Charles Grassley comment in 2007- "You can hardly swing a cat by the tail in Washington without hitting a pharmaceutical lobbyist,"

    Nothing against cat lovers, I have one of the little stinkers.

    My views of Pharma lobbying in general -
    If that many dollars and numbers of lobbyist are blanketing Washington with a more or less unified goal, then:
    1. It’s a one sided game.
    2. Deceitful things are likely to be happening. I lean toward “are” rather than “likely”.
    3. Money is buying policy.

    I would love to know the ties that FDA Preemption and lobbying had in the years that the Bush administration was pushing its agenda. Washington and certainly the FDA must have known what was going on. Were lobbyists and lawyers working together on Preemption? I have no proof but I have to think so.

    For today - how much of health care reform will be guided by pharma through its lobbyists? Just looking at the numbers, pharma’s lobby spending trend is up drastically and the money has now shifting from Republican to the Democrat.

    From past activities and results the conclusion is obvious.

  32. Concerning Lobbying for Preemption see- THIS article from Forbes on PharmaLittle in June.

  33. I am sorry to be such a post hog, but it's a stay in-side day here and I need to get a life.

    The more I look at this the more unsettling it gets. HERE is a very interesting study from Common Cause called Legislating Under the Influence. Summary points are:
    (the complete study is worth a look)

    • Health industries – including health insurance, pharmaceuticals and health products, hospitals and HMOs, and health professionals – have contributed over $372 million in campaign contributions to members of Congress since 2000.

    • Political spending by the health industries has increased 73 percent since 2000. Health interests contributed about $94 million to candidates for Congress in the 2008 election cycle, up from about $54 million in the 2000 cycle.

    • Members serving on committees and subcommittees with jurisdiction over health care reform in the House and Senate received the lion's share of health industries' largesse. Committee members raised $178 million from the industries this decade – roughly half of the industries' contributions to the entire Congress. Since 2000, the House members sitting on health committees have raised twice as much money from the health industry per election cycle as non-committee members (an average of 171,000 compared to 87,000), and the average House member on a key health subcommittee hauled in three times as much per cycle ($269,000). Senators with plum committee posts also enjoy sizable fundraising advantages.

    • The industries engage in "switch-hitting" – shifting campaign contributions between Democrats and Republicans to win access with the party in power. In 2000, with Republicans controlling the House and a closely-divided Senate, Republicans on health-related committees received more than double what Democrats received (68 percent to 32 percent) from the health industries. In 2008, with Democrats controlling both the House and Senate, over 61 percent of the industries' contributions to committee members went to the majority Democrats and just 39 percent went to Republicans.

    • The major health interests have spent an average of $1.4 million per day to lobby Congress so far this year and are on track to spend more than half a billion dollars by the end 2009. That comes out to about $2,600 per day per member of the House and Senate. The pharmaceutical lobby alone spent $733,000 per day in the first quarter of 2009. Since 2000, the industries have spent over $3 billion on lobbying, with the total increasing every year and rising more than 142 percent over the course of the decade. In each of the past four years health interests have been the number-one lobbying force in Washington, measured in expenditures, and have averaged over $1 million per day.

  34. Yes. there has never been any question that preemption has been at the top of lobbyists' agenda. No secret about it. I have met some of those lobbyists in Michigan (also former state officials or their staff in many instances). Likewise, it is not for nothing that the national Chamber of Commerce called Levine the 'business case of the century." Having lost there, they are hard at work to prevent Congress from reversing Reigel via amending the MDA.

    This is the system we are in, with relatively few checks on the ways and extent to which interests of all kinds can attempt to influence political outcomes via "inducements" and "connections" and not simply debate.

    As relayed, I believe that meaningful reform is probably beyond the parameters of the U.S system as we know it. That said, some ages are more "gilded" than other. We are coming out of one that rivals the earlier age of robber barons, war profiteers, and the like.

  35. p.s. One easy way always to know who is on the House subcommittee on health is to go to opensecrets and see who received the largest campaign contributions from pharma in the most recent election cycle.

    There are a few exceptions. Waxman has always gotten squat (unlike Dingell and almost all the others). Wonder why.

  36. Justice,

    Thanks for the website tip

  37. It's a fantastic site. Lots to learn about lots of things.

    One of the assignments I give my students is to use the site to find out who are the top Congressional recipients of pharma campaign contributions.

    Then speculate on why that might be.

    (BTW, in general,it has far less to do with policy positions--whether people already tend to agree with PhRMA, for example--than their power position and committe membership in Congress. That's why Waxman an interesting exception to the general rule.)


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